Random inspection report
Care homes for older people
Name: Address: Lancaster House 2 Portal Avenue Watton Thetford Norfolk IP25 6HP two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Craig Date: 2 7 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Lancaster House 2 Portal Avenue Watton Thetford Norfolk IP25 6HP 01953883501 01953883501 annette.howarth@lancasterhousecarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jeeva Ekanayake,Mr Sarath Ekanayake Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 19 Number of places (if applicable): Under 65 Over 65 19 old age, not falling within any other category Conditions of registration: 0 Nineteen (19) Older People may be accommodated. Date of last inspection Brief description of the care home Lancaster House was originally built as officers quarters for the RAF and is situated near the entrance to the former barracks on the outskirts of the Breckland town of Watton. The barracks are no longer operational and have since become a private residential area. The house itself has been extended and adapted to provide residential care for a maximum of 19 older persons. The accommodation is all within single rooms. The 10 ground floor rooms all have en suite facilities. The upper floor is
Care Homes for Older People Page 2 of 10 Brief description of the care home accessible by a stair lift and rooms in the older part of the house have wash-basins and share toilet facilities that are close by. The care home has a large and pleasantly appointed lounge dining room with 2 access points out into the rear garden. All the main doors into the house have ramped access. There is a private car park at the front of the building. Fees vary according to the needs of the individual and a full breakdown can be obtained direct from the home. A statement of purpose and a service user guide can be obtained from the home by post or by collecting a copy in person. Care Homes for Older People Page 3 of 10 What we found:
After our last key inspection on 8th July 2008 we judged Lancaster House to be providing good outcomes for the people who use the service. We carried out two random inspections on 29th June 2009 and 26th October 2009 because of concerns about the financial viability of the home. In December 2009 the home went into administration and we were notified that Healthcare Management Solutions Limited (HMS) had been appointed to oversee the operation and management of Lancaster House. In March 2010 we were notified that the manager was on sick leave and in April we received concerns about staffing issues and the lack of management and leadership in the home. We wrote to HMS requesting confirmation that there were adequate arrangements in place for managing the service in the absence of the manager but did not receive a response. Therefore, we carried out this random inspection to check on the day to day management of the home and the impact, if any, on the people who use the service. The manager had been absent for over a month and started a phased, return to work programme the day before our visit. In her absence the home had been run by two senior carers, both of whom had some management experience. However, they were not provided with any supernumerary time and as a consequence some of the regular management and administration tasks had not been kept up to date. We looked at care records to check that people using the service had an up to date plan to instruct staff how their care needs were to be met. We found that a new format for care plans and associated records had been introduced over the past few weeks. Staff were in the process of transferring all information onto the new documents and drawing up new plans but this was not complete. Some staff had been paid to come in on their day off to do some paperwork but in general they had to absorb the extra work into their existing hours. One of the care files we looked at did not include any care plans at all. Staff told us that because there was a regular staff team, who knew the resident very well, her care needs were being met as usual. Staff also had the old care plans to refer to if necessary. Staff had not had any training on writing the new plans, which one member of staff said were, very different. A representative from HMS was due to provide some training in the following week. We looked briefly at medicines management to ensure that it was safe and people were receiving their medication as it was prescribed. In March 2010 an external medication audit had been carried out, which had identified a number of issues where practice needed to be improved. For example, medication records were not complete and some preparations were not dated on opening to ensure they were not used beyond the recommended period. We found that these issues had been resolved and there had been improvements in all areas. Most of the staff and residents told us that there was very little entertainment or activity going on. One resident said, We dont have much in the way of activities, and another said they would like a bit more entertainment. One of the care staff did some extra hours to provide activities three times a week but this was not consistent. We looked at how complaints and safeguarding issues were managed. There had been no recent complaints. There had been an incident of money going missing in February and
Care Homes for Older People Page 4 of 10 the manager had made an appropriate referral to the Police and social services. The investigation had not concluded by the time of our visit. There had been no further safeguarding incidents. Some parts of the environment needed attention. A relative told us that they had been disappointed that a torn carpet had not yet been replaced and a member of staff said a relative had also complained about the worn and stained carpet in their relatives bedroom. A senior member of staff said that new carpets and blinds for the sun room were on order. The staff did not know of any plans to replace the bath, which had a damaged surface and could present an infection control risk. There have been two previous requirements to replace the bath, which is the only one in the home. We were told that the planned staffing levels were, three staff on duty at all times during the day. This included a senior. The staff rotas showed that these levels were not always met, especially at weekends. Existing staff picked up some extra shifts but there were twelve shifts, over a four week period, where there were only two staff on duty. Staff told us that they made sure that residents received the support they needed with personal care tasks but that they were not able to spend time with them. Residents told us that they were sometimes short of staff and the girls had to rush around. One said, I have noticed shortages, if there are only two of them I dont always get a shower but we get through it, its not the carers fault, everyone of them are lovely. A relative told us that their main concern was about lack of staff but they believed that residents were not being neglected in any way. Senior staff told us that they have had recent agreement that they can use agency staff to cover future shortfalls but they have not been given any details of which agency they can contact. They are currently trying to recruit new staff. We looked at the file of a recently appointed member of staff and found that safe recruitment practices had not been followed. Their application form had not been completed in full, there were no references and no evidence of a Criminal Records Bureau check to ensure that they were fit to work with vulnerable adults. There was no evidence that they had received induction training, which was usually carried out by the manager. Staff told us that they had not received any training for over 18 months. Refresher training in health and safety topics, such as fire safety, moving and handling and infection control was overdue. Dates had been arranged for some of these topics but not all. Most staff had not received supervision for some time. Staff told us that morale was low. One told us, There have been problems since the manager went off, there is no-one at the helm. Most of the staff we spoke to blamed low morale on the lack of information about their future, a change in terms and conditions of employment, working extra shifts and working short of staff. Despite obvious difficulties within the staff team, this had not been communicated to residents and relatives, who had nothing but praise for them. For example, a resident told us, There is a good atmosphere, and a relative said, Hats off to the staff, they have really tried to keep things right through the upheaval. The annual quality assurance assessment (AQQA) that the manager sent to us was not completed in all areas. There was a lack of information about the servicing and testing of some of the equipment in the home. During our visit we were unable to find any evidence of up to date servicing or testing of portable appliances, the stair lift and gas appliances. Care Homes for Older People Page 5 of 10 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Everyone using the service 30/06/2010 must have an up to date care plan, which sets out their health, personal and social care needs and how they are to be met. This is to ensure that staff have appropriate directions about the support they need to give. 2 21 13 The bath to be replaced due to the poor condition of the surface. This is because it may increase the risk of cross infection and it is not pleasant for residents to have to use. 31/08/2010 3 27 18 There must be sufficient staff 31/05/2010 on duty at all times to meet the assessed needs of the people using the service. This is to ensure that people receive the care and attention they need. Care Homes for Older People Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 4 29 19 Staff must have appropriate 14/05/2010 pre-employment checks and the required records must be obtained and retained on file. This is to provide safeguards for people using the service. 5 30 18 Staff must receive training appropriate to their roles, including induction training. To ensure that staff have the necessary skills to promote the health, safety and welfare of people using the service. 30/07/2010 6 38 13 Equipment and appliances 31/05/2010 used in the home must be maintained and records of testing and servicing must be available. This includes: The stair life, gas appliances and portable electrical appliances. To protect the health and safety of people living and working at the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 12 The service should provide sufficient organised activities to meet the social and recreational needs of people using the service. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
